{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T17:03:39Z","timestamp":1792515819322,"version":"4.5.0"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"Supplement_2","license":[{"start":{"date-parts":[[2021,7,27]],"date-time":"2021-07-27T00:00:00Z","timestamp":1627344000000},"content-version":"vor","delay-in-days":26,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Research Foundation\u2014Flanders (FWO","award":["2I6319N"],"award-info":[{"award-number":["2I6319N"]}]},{"name":"University of Antwerp scientific chair in Evidence-Based Vaccinology"},{"DOI":"10.13039\/100004319","name":"Pfizer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004330","name":"GSK","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004330","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Methusalem finance programme of the Flemish Government"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Data on antibiotic consumption in the community were collected from 30 EU\/EEA countries over two decades. This article reviews temporal trends, seasonal variation, presence of change-points and changes in the composition of the main antibiotic groups.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>For the period 1997\u20132017, data on consumption of antibiotics, i.e. antibacterials for systemic use (ATC group J01), in the community, aggregated at the level of the active substance, were collected using the WHO ATC\/DDD methodology (ATC\/DDD index 2019). Consumption was expressed in DDD per 1000 inhabitants per day and in packages per 1000 inhabitants per day. Antibiotic consumption was analysed based on ATC-3 groups, and presented as trends, seasonal variation, presence of change-points and compositional changes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In 2017, antibiotic consumption in the community expressed in DDD per 1000 inhabitants per day varied by a factor 3.6 between countries with the highest (Greece) and the lowest (the Netherlands) consumption. Antibiotic consumption in the EU\/EEA did not change significantly over time. Antibiotic consumption showed a significant seasonal variation, which decreased over time. The number of DDD per package significantly increased over time. The proportional consumption of sulphonamides and trimethoprim (J01E) relative to other groups significantly decreased over time, while the proportional consumption of other antibacterials (J01X) relative to other groups significantly increased over time.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Overall, antibiotic consumption in the community in the EU\/EEA did not change during 1997\u20132017, while seasonal variation consistently decreased over time. The number of DDD per package increased during 1997\u20132017.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jac\/dkab172","type":"journal-article","created":{"date-parts":[[2021,5,12]],"date-time":"2021-05-12T19:13:45Z","timestamp":1620846825000},"page":"ii7-ii13","source":"Crossref","is-referenced-by-count":63,"title":["Consumption of antibiotics in the community, European Union\/European Economic Area, 1997\u20132017"],"prefix":"10.1093","volume":"76","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4217-2869","authenticated-orcid":false,"given":"Robin","family":"Bruyndonckx","sequence":"first","affiliation":[{"name":"Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium"},{"name":"Interuniversity Institute for Biostatistics and statistical Bioinformatics (I-BIOSTAT), Data Science Institute, Hasselt University, Hasselt, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niels","family":"Adriaenssens","sequence":"additional","affiliation":[{"name":"Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium"},{"name":"Centre for General Practice, Department of Family Medicine & Population Health (FAMPOP), University of Antwerp, Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann","family":"Versporten","sequence":"additional","affiliation":[{"name":"Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niel","family":"Hens","sequence":"additional","affiliation":[{"name":"Interuniversity Institute for Biostatistics and statistical Bioinformatics (I-BIOSTAT), Data Science Institute, Hasselt University, Hasselt, Belgium"},{"name":"Centre for Health Economic Research and Modelling Infectious Diseases, Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominique L","family":"Monnet","sequence":"additional","affiliation":[{"name":"Disease Programmes Unit, European Centre for Disease Prevention and Control, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geert","family":"Molenberghs","sequence":"additional","affiliation":[{"name":"Interuniversity Institute for Biostatistics and statistical Bioinformatics (I-BIOSTAT), Data Science Institute, Hasselt University, Hasselt, Belgium"},{"name":"Interuniversity Institute for Biostatistics and statistical Bioinformatics (I-BIOSTAT), Catholic University of Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herman","family":"Goossens","sequence":"additional","affiliation":[{"name":"Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaus","family":"Weist","sequence":"additional","affiliation":[{"name":"Disease Programmes Unit, European Centre for Disease Prevention and Control, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1238-8052","authenticated-orcid":false,"given":"Samuel","family":"Coenen","sequence":"additional","affiliation":[{"name":"Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium"},{"name":"Centre for General Practice, Department of Family Medicine & Population Health (FAMPOP), University of Antwerp, Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the ESAC-Net study group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reinhild","family":"Strauss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eline","family":"Vandael","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefana","family":"Sabtcheva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arjana Tambi\u0107","family":"Andra\u0161evi\u0107","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isavella","family":"Kyriakidou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji\u0159\u00ed","family":"Vl\u010dek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ute Wolff","family":"S\u00f6nksen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elviira","family":"Linask","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmi","family":"Sarvikivi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karima","family":"Hider-Mlynarz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doreen","family":"Richter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flora","family":"Kontopidou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00e1ria","family":"Matuz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gudrun","family":"Aspelund","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Burns","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filomena","family":"Fortinguerra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"El\u012bna","family":"Dimina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jolanta","family":"Kuklyt\u0117","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcel","family":"Bruch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Zarb","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Natsch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hege Salvesen","family":"Blix","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Olczak-Pie\u0144kowska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Silva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel Adrian","family":"Popescu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom\u00e1\u0161","family":"Tesa\u0159","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milan","family":"\u010ci\u017eman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio L\u00f3pez","family":"Navas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vendela","family":"Bergfeldt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Hopkins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,8,1]]},"reference":[{"key":"2021090121421723400_dkab172-B1","doi-asserted-by":"crossref","first-page":"1514","DOI":"10.1016\/j.addr.2005.04.005","article-title":"Clinical impact and relevance of antibiotic resistance","volume":"57","author":"French","year":"2005","journal-title":"Adv Drug Deliv Rev"},{"key":"2021090121421723400_dkab172-B2","year":"2020"},{"key":"2021090121421723400_dkab172-B3","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1093\/jac\/dkl188","article-title":"European Surveillance of Antimicrobial Consumption (ESAC): outpatient antibiotic use in Europe","volume":"58","author":"Ferech","year":"2006","journal-title":"J Antimicrob Chemother"},{"key":"2021090121421723400_dkab172-B4","doi-asserted-by":"crossref","first-page":"vi3","DOI":"10.1093\/jac\/dkr190","article-title":"European Surveillance of Antimicrobial Consumption (ESAC): outpatient antibiotic use in Europe (1997-2009)","volume":"66","author":"Adriaenssens","year":"2011","journal-title":"J Antimicrob Chemother"},{"issue":"Suppl 2","key":"2021090121421723400_dkab172-B5","first-page":"ii2\u2013ii6","article-title":"Consumption of antibiotics in the community, European Union\/European Economic Area, 1997\u20132017: data collection, management and analysis","volume":"76","author":"Bruyndonckx","year":"2021","journal-title":"J Antimicrob Chemother"},{"key":"2021090121421723400_dkab172-B6","year":"2018"},{"issue":"Suppl 2","key":"2021090121421723400_dkab172-B7","first-page":"ii79\u2013ii85","article-title":"Analysing the trend over time of antibiotic consumption in the community: a tutorial on the detection of common change-points","volume":"76","author":"Bruyndonckx","year":"2021","journal-title":"J Antimicrob Chemother"},{"key":"2021090121421723400_dkab172-B8","doi-asserted-by":"crossref","first-page":"vi89","DOI":"10.1093\/jac\/dkr461","article-title":"Analysing the composition of outpatient antibiotic use: a tutorial on compositional data analysis","volume":"66","author":"Faes","year":"2011","journal-title":"J Antimicrob Chemother"},{"issue":"Suppl 2","key":"2021090121421723400_dkab172-B9","first-page":"ii14\u2013ii21","article-title":"Consumption of penicillins in the community, European Union\/European Economic Area, 1997\u20132017","volume":"76","author":"Bruyndonckx","year":"2021","journal-title":"J Antimicrob Chemother"},{"issue":"Suppl 2","key":"2021090121421723400_dkab172-B10","first-page":"ii22\u2013ii29","article-title":"Consumption of cephalosporins in the community, European Union\/European Economic Area, 1997\u20132017","volume":"76","author":"Versporten","year":"2021","journal-title":"J Antimicrob Chemother"},{"issue":"Suppl 2","key":"2021090121421723400_dkab172-B11","first-page":"ii30\u2013ii36","article-title":"Consumption of macrolides, lincosamides and streptogramins in the community, European Union\/European Economic Area, 1997\u20132017","volume":"76","author":"Adriaenssens","year":"2021","journal-title":"J Antimicrob Chemother"},{"issue":"Suppl 2","key":"2021090121421723400_dkab172-B12","first-page":"ii37\u2013ii44","article-title":"Consumption of quinolones in the community, European Union\/European Economic Area, 1997\u20132017","volume":"76","author":"Adriaenssens","year":"2021","journal-title":"J Antimicrob Chemother"},{"issue":"Suppl 2","key":"2021090121421723400_dkab172-B13","first-page":"ii45\u2013ii59","article-title":"Consumption of tetracyclines, sulphonamides and trimethoprim, and other antibacterials in the community, European Union\/European Economic Area, 1997\u20132017","volume":"76","author":"Versporten","year":"2021","journal-title":"J Antimicrob Chemother"},{"key":"2021090121421723400_dkab172-B14","doi-asserted-by":"crossref","first-page":"E3463","DOI":"10.1073\/pnas.1717295115","article-title":"Global increase and geographic convergence in antibiotic consumption between 2000 and 2015","volume":"115","author":"Klein","year":"2018","journal-title":"Proc Natl Acad Sci USA"},{"key":"2021090121421723400_dkab172-B15","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/j.jhin.2019.03.001","article-title":"Seasonality and community interventions in a mathematical model of Clostridium difficile transmission","volume":"102","author":"McLure","year":"2019","journal-title":"J Hosp Infect"},{"key":"2021090121421723400_dkab172-B16","article-title":"Mayo Clin Proc Innov Qual Outcomes 2020; 4: 31\u20139","author":"Walsh"},{"key":"2021090121421723400_dkab172-B17","doi-asserted-by":"crossref","first-page":"429","DOI":"10.3399\/bjgp12X649124","article-title":"Antibiotics for acute cough: an international observational study of patient adherence in primary care","volume":"62","author":"Francis","year":"2012","journal-title":"Br J Gen Pract"},{"issue":"Suppl 2","key":"2021090121421723400_dkab172-B18","first-page":"ii60\u2013ii67","article-title":"Quality appraisal of antibiotic consumption in the community, European Union\/European Economic Area, 2009 and 2017","volume":"76","author":"Adriaenssens","year":"2021","journal-title":"J Antimicrob Chemother"},{"key":"2021090121421723400_dkab172-B19","year":"2018"},{"key":"2021090121421723400_dkab172-B20","doi-asserted-by":"crossref","first-page":"e001241","DOI":"10.1136\/bmjgh-2018-001241","article-title":"Estimating global trends in total and childhood antibiotic consumption, 2011-2015","volume":"4","author":"Jackson","year":"2019","journal-title":"BMJ Glob Health"},{"key":"2021090121421723400_dkab172-B21","volume-title":"AMC Data 2011\u20132017","year":"2020"},{"key":"2021090121421723400_dkab172-B22","doi-asserted-by":"crossref","DOI":"10.1080\/17843286.2020.1721135","article-title":"Antibiotic use and resistance in Belgium: the impact of two decades of multi-faceted campaigning","author":"Bruyndonckx","year":"2021","journal-title":"Acta Clin Belg"}],"container-title":["Journal of Antimicrobial Chemotherapy"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jac\/article-pdf\/76\/Supplement_2\/ii7\/40215682\/dkab172.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jac\/article-pdf\/76\/Supplement_2\/ii7\/40215682\/dkab172.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T21:45:18Z","timestamp":1630532718000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jac\/article\/76\/Supplement_2\/ii7\/6328677"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,1]]},"references-count":22,"journal-issue":{"issue":"Supplement_2","published-online":{"date-parts":[[2021,8,1]]},"published-print":{"date-parts":[[2021,8,1]]}},"URL":"https:\/\/doi.org\/10.1093\/jac\/dkab172","relation":{},"ISSN":["0305-7453","1460-2091"],"issn-type":[{"value":"0305-7453","type":"print"},{"value":"1460-2091","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,7,1]]},"published":{"date-parts":[[2021,7,1]]}}}